1. Glenohumeral Joint
Jessica Vila
&
Carrie A. Hoch

2. Ligaments Anterior view        

3. Bursae  subacromial bursa  subdeltoid bursa  subcoracoid bursa
 subscapular bursa

4. Cartilage and Articular Capsule
glenoid labruim 
 synovial membrane
articular cartilage 
glenoid labruim 
synovial membrane 
fibrous layer 
Anterior/sliced view

5. intertubercular sulcus
Humerus
anatomical neck
head
anatomical neck
greater tubercle
surgical neck
lesser tubercle
intertubercular sulcus
surgical neck
deltoid tuberosity

6. Scapula ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗ Anterior view
superior angle ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗
subscapular
fossa ✗ ✗ ✗ ✗ ✗ ✗ ✗ ✗
Anterior view
Posterior view
inferior angle

7. Clavicle ⏎ ⏎

8. Rotator Cuff Muscles supraspinatus Rotator cuff teres minor
infraspinatus
subscapularis

9. Clinical Issues Common rotator cuff injuries:
Tendinitis = tendons are inflamed due to overuse or overload
Bursitis = bursa become irritated or inflamed
Strain or tear = can result from tendinitis or stress

10. Rotator Cuff Cont. Common causes:
Normal wear & tear - leads to breakdown of collagen in tendons and muscles
Poor posture - muscle or tendons can become pinched under clavicle
Falling - breaking fall w/ arm or falling onto arm can bruise or tear tendon or muscles

11. Common Causes Cont.
Lifting or pulling – can strain or tear tendons or muscles
Repetitive stress – repetitive overhead movement can result in inflammation and tearing in tendons or muscles

12. Risk Factors Age - most common in people > 40
Athletes - pitchers, tennis players
Construction trades – painters, carpenters
Weak shoulder muscles

13. Surface Anatomy
Essential Clinical Anatomy p. 428

14. acromial part
of deltoid
middle part
of trapezius
spinal part
of deltoid
ascending part
of trapezius
triangle of
auscultation

15. descending part
of trapezius
clavipectoral
triangle
clavicle
clavicular part
of deltoid
clavicular head of
pectoralis major

17. manubrium
sternocostal head
pectoralis major
posterior
axillary
fold
anterior
axillary
fold

18. Accessory Nerve XI, Cervical & Brachial Plexus⏎
Cervical plexus C1-C4 ⏎

19. Nerves ✪ Brachial Plexus C5-T1 ✪ ✪ ✪ ✪ ✪ ✪ ✪ ✪ ✪ ✪

20. Brachial Plexus ✪ ✪

21. Arteries ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ ✓ Deep Scapular artery????
circumflex scapular a. ✓ ✓
Deep Scapular artery????

22. Veins   

23. Anterior Deltoid Origin: Lateral third of clavicle
Insertion: Deltoid tuberosity
Action: Shoulder flexion, Medial Rotation, Horizontal ADDuction
Innervation: Axillary Nerve
Vascular supply: Posterior Circumflex
artery

24. Middle Deltoid Origin: Acromion process Insertion: Deltoid Tuberosity
Action: Shoulder ABDuction
Innervation: Axillary nerve
Vascular supply: Posterior circumflex artery
Middle Deltoid

25. Posterior Deltoid Origin: Spine of Scapula
Insertion: Deltoid Tuberosity
Action: Shoulder extension, hyperextension, lateral rotation and horizontal ABDuction
Innervation: Axillary Nerve
Vascular Supply: Posterior Circumflex artery

26. Pectoralis Major (clavicular and sternal portions)
Origin: Medial third of clavicle, sternum, costal cartilages of the first six ribs
Insertion: Lateral lip of bicipital groove of humerus
Action: Shoulder ADDuction, medial rotation and horizontal ADDuction
Innervation: Lateral and medial pectoral nerve
Vascular Supply: Lateral thoracic artery

27. 1.)Teres Minor 2.) Teres Major 1 2 Origin: Axillary border of scapula
Insertion: Greater tubercle of Humerus
Action: Shoulder Lateral rotation horizontal
and horizontal ABDuction
Innervation: Axillary nerve
Vascular supply: Circumflex scapular artery
2.) Teres Major
Origin: Axillary border of scapula (near the inferior angle) Insertion: Crest below lesser tubercle next to the latissimus dorsi muscle attachment Action: Shoulder extension, ADDuction and medial rotation
Innervation: Subscapular nerve 1 2

28. Latissimus Dorsi
Origin: Lower three ribs, Spinous processes of T7 through L5( via dorsolumbar fascia), posterior surface of sacrum and iliac crest.
Insertion: Medial lip of bicipital groove of humerus
Action: Shoulder extension, ADDuction, medial rotation and hyperextension
Innervation: Thorocodorsal nerve
Vascular supply: DEEP scapular nerve

29. 1.) Subscapularis Origin: Subscapular fossa of the scapula
Insertion: Lesser tubercle of the humerus
Action: Shoulder medial rotation
Innervation: Subscapular nerve
Vascular supply: Subscapular artery 1 2 3

30. 2.)Supraspinatus Origin: Supraspinous fossa of the scapula Action: Shoulder ABDuction1 2 3
3.)Infraspinatus Origin: Infraspinous fossa of scapula Action: Shoulder Lateral rotation horizontal and ABDduction
The Supraspinatus and Infraspinaus have the same:
Insertion : Greater tubercle of the Humerus
Innervation : Suprascapular nerve
Vascular Subscapular artery

31. Trapezius 1 2 3 Upper Trapezius Middle Trapezius Lower Trapezius
Origin: Occipital bone, nuchal ligament
Insertion: Outer third of clavicle, acromion process
Action: Scapular elevation and upward rotation
Middle Trapezius
Origin: Spinous process of C7 through T3
Insertion: Scapular Spine
Action: Scapular depression
Lower Trapezius
Origin: Spinous processes of middle and lower thoracic vertebrae
Insertion: Base of scapular spine
Action: Scapular depression and upward rotation
Innervation of all Three: Spinal accessory (cranial nerve XI)
Vascular supply of all Three: Transverse cervical artery 1 2 3

32. Levator Scapulae
Origin: Transverse process of first four cervical vertbrae
Insertion: Vertebral border of scapula between the superior angle and spine
Action: Scapular elevation and downward rotation
Innervation: Third and fourth cervical nerve
Vascular supply: Dorsal scapular artery

33. Pectoralis minor Origin: Anterior Surface, third through fifth ribs
Insertion: Coracoid process of the scapula
Action: With ribs fixed: draws the scapula forward(ABDucts) and rotates scapula downward against the thoracic wall
With scapula fixed: elevated the rib cage
Innervation: Medial pectoral nerve
Vascular supply: Axillary artery

34. Serratus Anterior Origin: Lateral surface of the upper eight ribs
Insertion: The anterior surface of vertebral border of the scapula
Action: Scapular protraction and upward rotation
Innervation: Long thoracic nerve
Vascular supply: Lateral thoracic artery

35. The RHOMBOIDES!!! 1.) Rhomboideus minor 2.) Rhomboideus MAJOR: 1 2
Origin: Spinous processes of C7 through T1
Insertion: Vertebral border of scapula at the spine process 1 2
2.) Rhomboideus MAJOR:
Origin: Spinous processes of T2 through T5
Insertion: Vertebral border of scapula between the spine and inferior angle
The Rhomboideus major and the Rhomboideus major have the same:
Action: Scapular retraction and downward rotation
Innervation: Dorsal scapular nerve
Vascular supply: Dorsal scapular artery

36. Coracobrachialis Origin: Coracoid process
Insertion: Medial aspect of humerus
Action: Weakly ADDucts shoulder joint
Innervation: Musculocutaneous nerves, C6 and C7
Vascular Supply: Brachial Artery

37. Study Reference

38. Study Reference

40. !
Who is this handsome man?